Prostatic malakoplakia mimicking prostate cancer in an elderly male with prostatitis: A rare but important differential

We report the case of an 81-year-old male presenting with lower urinary tract symptoms and a PSA of 39 ng/mL, initially attributed to <i>Escherichia coli</i> prostatitis. Despite PSA normalization with antibiotics, MRI demonstrated a PIRADS 5 lesion in the left transition zone. Histopathological evaluation following transperineal biopsy revealed prostatic malakoplakia. This rare granulomatous condition can mimic prostate cancer both clinically and radiologically. Our case highlights the importance of histological confirmation in atypical presentations to avoid misdiagnosis and overtreatment.